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Poor weight gain??

Hi Ladies! I haven't posted here much, but I read lots. lol I have a little boy 4 months old today. Had his well visit this morning...weight gain=not good. 3 weeks ago he was in for a visit...older brother shared some germs. He was there on Monday & again on Wednesday. He gained 4 ozs from Mon-Wed. He had been doing really well. I'm really upset. We haven't had a problem with this before, so I'm not sure why it's coming up now. My ped is VERY pro-breastfeeding, so he is giving me a month to work on it. He did suggest starting cereal with him...although I did not want to do that until at least 6 months. LO has been fussy at the breast lately, but I thought his gums were bothering him. He would begin sucking eagerly, only to pull off and fuss. When he is awake, he is constantly drooling/biting on his fingers...so teething was my thought. He roots like normal and had been acting normal otherwise. He has typically at least 2 poops a day-all still yellow/runny. He has at least 6?? Wet diapers per day. I haven't been counting really...I just change him and go on. Eariler on, I had tried to pump a bit to have some milk on hand, but I abadoned that as I would only get about 1 oz per pumping session...and I just don't have time for that! LOL.. Just put him on me and go with it. I have not supplimented with formula at all, so he isn't getting anything other than breastmilk. He nurses every 21/2 to 3 hrs all day long..sometimes every 2...just whatever he wants...The only thing, he has been sleeping longer stretches at night, at least 4 hrs at a time, a few nights going 8-9. (WOW!) I was happy about that until the dr. appt today. Oh and he HAS gained in length. He was 5 lbs. 15 oz at birth 20 in. long. He is now 10 lbs 12 oz & 25 inches long at 4 months old. Any help would be great! Thanks! (also...we nurse with a medela nipple shield-he had an receeding lower lip/chin at birth...couldn't latch without it at all. I tried to wean him from it several times without success, but it only frustrated him & me. I decided to let it go for now to just enjoy feeding him...and since he was gaining well & I wasn't having a problem...I figured it was much better to nurse with a sheild than to bottle feed. Please don't hate on me for this, I struggled with PPD, so I just needed 1 less emotional thing to deal with.) Thanks for any help.

Re: Poor weight gain??

Can you post a weight history on your LO? (Birth weight, lowest weight, weight at each checkup.) That data may help us figure out if your baby's gain is normal, or worrisome. Also- is he growing well in length, is his head circumference increasing, is he meeting milestones, is he becoming mobile?

Re: Poor weight gain??

Thanks for sharing all that! Based on what you've posted, I think there's reason to be cautious, but not reason to panic. It seems like your baby has been consistently on the small side- he was born small, and he has continued to follow more or less the same curve on this chart for breastfed babies ever since. It's okay to be small- there are healthy babies in all percentiles, and statistically speaking there are just as many healthy babies in the 1st percentile as there are in the 99th. It's especially okay to be small when the other indicators of growth- length and head circumference- remain normal, and when the baby is mastering developmental milestones at a normal pace. All of that, coupled with the fact that you're nursing on demand and seeing a nice, normal pattern of pee/poop, indicates to me that your baby is on track.

That being said, it's possible that your baby has slipped a bit because he had a rough month after catching his brother's germs. That means it's a good time to be watchful with respect to weight gain. It's also a great time to work on getting rid of the shield. I don't mean to guilt you about the shield since it is a very valuable tool for many mom/baby pairs! But it can sometimes slow milk transfer, leading to decreased intake during feedings. So if you can just offer the bare breast a few times a day, in a no-pressure manner, and see what happens- who knows? Perhaps your baby will decide to give it a try!

One thing I would absolutely NOT do at this point is give cereal. Cereal is not a calorie-rich food, especially in comparison to breastmilk. If you wanted to gain weight, what would you choose: a bowl of rice mush or a milkshake? One thing cereal does have is vitamins- but you can give those via dropper without impacting your baby's breastmilk consumption.

Re: Poor weight gain??

Thanks! I talked to the lc at our hospital, and she suggested that it was possibly due to his illness since he had been right on track gaining well prior to that. Made me feel a "bit" better. I had forgotten earlier to say that he is meeting milestones and was even doing a few things that my ped said was a whole month and a half early. I jokingly said, well there is all his calories right there. lol
LC suggested trying to pump 2x a day and offering the EBM after a few nursing sessions to try to jump start him back to where he was before. She is suggesting that he was struggling to eat while he was sick and just sort of got "used to" eating less or just maintaining his weight, etc. She is hoping that by offering a bit of supplimentation that his body will kick back into gear, and start nursing more effectively once again. I'm supposed to call her again next week, take him in and get him weighed. We shall see.
It's funny on the shield thing. He will take the bare breast at times...then other times he won't and gets all huffy with me about it. There have been several times that I thought we were done with it, only to have to go right back to using because he refused to nurse without it....even though the prior feeding he took it bare. He especially gets mad when I try to stop him mid-feed and slip it off. Boy that ticks him off. Thoughts on that? Sorry to be touchy earlier...I have just had some people (not on here) get testy about them...and I know it's not perfect...but it was helping me at 1st.
Back to the weight issue, dh & I are both smaller people as well...so our LO isn't going to be high on the chart by any stretch of the imagination. Our older son, we adopted from India...he is always off the bottom of the American chart as well...but he follows the curve even though he isn't really on it. LOL. Thankfully their ped is also Indian, so he is relaxed about the growth chart issue.
Anyways...rambling..but thank you for your support. Much appreciated.